Individual provider Active NPI

Katherine Rose Priebe, PSY.D., P.C

  • Mental Health Counselor
  • Hudson, WI
National Provider Identifier
1477072999
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
3594 Issued in WI
Practice address
2501 Hanley Rd
Hudson, WI 54016-8705
Phone
(651) 214-4381
NPI assigned
Sep 15, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 3594 WI Primary

Addresses

Primary practice location

2501 Hanley Rd
Hudson, WI 54016-8705

Mailing address

2501 Hanley Rd
Hudson, WI 54016-8705
Phone (651) 214-4381

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240405003244 WI Practitioner - Mental Health Counselor 4880032036 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2013
Medicare assignment
May accept Medicare assignment
Group practices
Allied Mental Health Specialty Group SCGroup PAC ID 9234155136, 3 clinicians

Practice addresses (Care Compare)

1334 Hosford St
Suite B
Hudson, WI 54016-9230
Phone (715) 808-0795

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3594WIMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Allied Mental Health Specialty Group SC CurrentSince Feb 17, 2024 Accepting new patients

Locations

1334 Hosford St
Ste B
Hudson, WI 54016
Phone (715) 808-0795

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1505433600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1477072999",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2501 HANLEY RD",
            "city": "HUDSON",
            "state": "WI",
            "postal_code": "540168705",
            "telephone_number": "651-214-4381"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2501 HANLEY RD",
            "city": "HUDSON",
            "state": "WI",
            "postal_code": "540168705",
            "telephone_number": "651-214-4381"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRIEBE",
        "first_name": "KATHERINE",
        "middle_name": "ROSE",
        "name_prefix": "Mrs.",
        "credential": "PSY.D., P.C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-09-15",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "WI",
            "license": "3594",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hudson, WI

Sources for this page

Verify at the official NPI Registry.